JP7623341B2 - Filtered tubing set for use with a gas delivery device for performing an endoscopic surgical procedure in a surgical cavity - Patents.com - Google Patents

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of priority to U.S. Patent Application No. 16/015,462, filed June 22, 2018, the disclosure of which is incorporated herein by reference in its entirety.

FIELD OF THEINVENTION The present invention is directed to a surgical gas delivery device for use in endoscopic surgery, and more specifically, to an endoscopic surgical procedure that includes an internal or remote gas seal module for generating a gas seal within a lumen extending from the lumen, which communicates with a mechanically sealed surgical access port to maintain a stable pressure within the surgical cavity.

Hermetically sealed surgical access devices or trocars, such as those disclosed in commonly assigned U.S. Pat. Nos. 7,854,724 and 8,795,223, may be used in conjunction with commonly assigned U.S. Pat. Nos. 8,715,219, 8,961,451, 9,295,461, and 9,315,471.
Use in combination with multi-mode gas delivery devices such as those disclosed in US Pat. Nos. 9,375,539 and 9,490 has demonstrated numerous advantages, including valve-free access to surgical cavities (e.g., abdominal or thoracic cavities), enhanced smoke evacuation, and stable maintenance of pressure within the surgical cavity, as well as several medical and clinical advantages.

The combination of these devices forms a surgical system that relies on the presence of an annular jet assembly housed within the trocar to receive pressurized gas from a gas delivery device to create a gas seal region within the body of the trocar. The annular jet assembly is disclosed in commonly assigned U.S. Patent No. 9,907,569 and is designed to provide a static mechanism, similar to a nozzle, that directs pressurized gas into a narrow passageway that increases the velocity of the gas to create the gas seal region.

In commonly assigned U.S. Patent Nos. 9,387,295 and 9,387,296, and commonly assigned U.S. Patent Application Publication No. 2016/0287817, it was proposed to move the location of the annular jet assembly (or similar nozzle design) from the trocar device into a filter cartridge housing of an associated filtered tube configured for operation in conjunction with a gas delivery device, thereby allowing the use of more conventional commercially available access devices in place of the hermetically sealed trocars described above.

It has been determined that further advantages can be achieved by moving the location of the annular jet assembly (or similar nozzle design) into the tubes of a filtered tubing set or into the housing of the multi-mode gas delivery device itself. This allows the technology to be compatible with many new proprietary and commercially available end effectors and access devices. Indeed, certain surgical scenarios may require that all access ports used in the procedure be of one type. For example, these include:
This may include robotic assisted surgery that is only compatible with certain types or brands of reusable cannulas.

Another advantage of the gas management system of the present invention is that it is market or cost driven, where hospitals have policies (e.g., through financial agreements) to use specific brands of disposable or reusable cannulas to save money. In these embodiments, the system of the present invention allows the surgeon to obtain pressure stability and smoke evacuation capabilities without having to substitute one of the lower cost access ports.

The present invention is directed to a new and useful system for performing an endoscopic surgical procedure within a surgical cavity, including a gas delivery device configured to deliver a flow of pressurized gas to a gas delivery lumen tube extending therefrom, a gas seal module in communication with a distal end of the gas delivery lumen tube and configured to create a gas seal within a gas seal lumen tube extending therefrom, and an access port in communication with the distal end of the gas seal lumen tube to provide mechanically sealed instrument access to the surgical cavity and maintain a stable pressure within the surgical cavity. The access port includes a valve seal proximal housing for providing mechanically sealed instrument access to the surgical cavity.

The system further includes a gas return lumen tube from the gas seal module back to the gas delivery device. The gas delivery device includes a pump for delivering pressurized gas to the gas delivery lumen tube and for aspirating gas from the gas return lumen tube. The gas delivery lumen tube and the gas return lumen tube communicate with a filter assembly sized and configured for receipt within the gas delivery device.

The system further includes an insufflation apparatus within the gas delivery device for delivering insufflation gas through an insufflation lumen tube to a second access port including a mechanically sealed proximal housing for providing sealed instrument access to the surgical cavity.

Preferably, the gas seal module includes a housing supporting a jet assembly for receiving pressurized gas from a gas delivery lumen tube to generate the gas seal, and gas expended in generating the gas seal is drawn through a gas return lumen tube to a pump in the gas delivery device. In one embodiment of the present invention, the gas seal module includes a vented housing to facilitate entrainment of air from the atmosphere into the surgical cavity and expulsion of gas from the surgical cavity to the atmosphere. It is also envisioned that the gas seal module communicates with a two-way filtration element to filter entrained air and/or gas expelled from the surgical cavity to the atmosphere.

In one embodiment, the housing of the gas seal module is configured such that the connection between the gas delivery lumen tube and the gas return lumen tube is disposed perpendicular to the connection between the gas seal lumen tube. In another embodiment, the housing of the gas seal module is configured such that the connection between the gas delivery lumen tube and the gas return lumen tube is disposed in-line with the connection between the gas seal lumen tube. In yet another embodiment, the housing of the gas seal module is configured such that the connection between the gas delivery lumen tube and the gas return lumen tube is disposed parallel to the connection between the gas seal lumen tube.

In these embodiments, it is envisioned that the gas delivery and gas return lumen tubes may be arranged to connect with the housing of the gas seal module in a side-by-side or concentric configuration. Alternatively, the gas seal module may include a two-part housing assembly having a proximal subassembly connected to the gas delivery and gas return lumen tubes and a distal subassembly connected to the gas seal lumen tube.

The present invention is also directed to a system for performing an endoscopic surgical procedure within a body cavity, the system including a gas delivery device having a pump for delivering pressurized gas to a gas delivery lumen tube extending therefrom, and an insufflation apparatus for delivering insufflation gas to the insufflation lumen tube extending therefrom. A gas seal module is configured to communicate with a distal end of the gas delivery lumen tube outside of the gas delivery device and to generate a gas seal within the gas seal lumen tube extending therefrom. A gas seal sleeve has a proximal end portion in communication with the distal end portion of the gas seal lumen tube, and a tubular access port configured to be coaxially mounted within the gas seal sleeve;
It has a valve seal proximal housing which provides mechanically sealed instrument access to the surgical cavity which communicates with the distal end of the air delivery lumen tube.

An annular channel is formed between an inner surface of the sleeve and an outer surface of the access port such that the gas seal lumen tube communicates with the surgical cavity to maintain a stable pressure within the surgical cavity. A seal ring is associated with a proximal end portion of the gas seal sleeve to seal a proximal end of the annular channel, and a plurality of circumferentially spaced flow passages are formed in a distal end portion of the gas seal sleeve to facilitate communication between the annular channel and the surgical cavity. The system further includes a gas return lumen tube from the gas seal module back to a pump in the gas delivery device. The gas delivery lumen tube and the gas return lumen tube communicate with a filter assembly sized and configured for receipt within the gas delivery device.

The present invention is also directed to a novel method of accessing a surgical cavity of a patient, comprising the steps of providing a gas seal sleeve, mounting a valve seal trocar within the gas seal sleeve, and introducing the gas seal sleeve with the mounted valve seal trocar into the surgical cavity of the patient. The method further includes connecting the sleeve to a gas seal lumen tube adapted for bidirectional gas flow into and out of the sleeve, and connecting the trocar to an air delivery lumen tube and a sensing lumen.

The present invention is also directed to a system for performing an endoscopic surgical procedure within a surgical cavity, the system including a gas delivery device housing a pump configured to deliver pressurized gas to an internal gas delivery lumen tube extending from the pump. A gas seal module is housed within the gas delivery device and configured to communicate with the gas delivery lumen tube and generate a gas seal within an internal gas seal tube extending therefrom. The gas seal lumen tube is adapted and configured to communicate with a gas seal lumen tube extending externally from the gas delivery device, and a valve seal access port communicates with a distal end of the gas seal lumen tube to provide mechanically sealed instrument access to the surgical cavity and maintain a stable pressure within the surgical cavity.

The system further includes an internal gas return lumen tube extending from the gas seal module for recirculating gas used to form the gas seal back to a pump in the gas delivery device.
The gas delivery device further includes an insufflation apparatus for delivering insufflation gas through the air insufflation lumen tube to the second valve seal access port.

In this embodiment of the invention, the gas seal module preferably includes an integral assembly formed by a metal disk having at least one radially inwardly angled nozzle formed therein for creating a gas seal, and a cylindrical bore for accommodating air ingress into and gas egress from the gas seal lumen tube.

It is envisioned that at least one radially inwardly angled nozzle may be radially spaced apart from a cylindrical bore that may be offset from a central axis of the disk. Alternatively, the disk may have multiple radially inwardly angled nozzles formed therein that are radially spaced apart from a cylindrical bore that may be offset from a central axis of the disk. Or, the disk may have multiple radially inwardly angled nozzles formed therein that surround a cylindrical bore that may be aligned with a central axis of the disk.

The present invention is also directed to a tubing set for use with a gas delivery device for performing an endoscopic surgical procedure within a surgical cavity, including a filter cartridge assembly having first and second flow paths formed therein, a first lumen tube extending from the filter cartridge and in communication with the surgical cavity for maintaining a stable pressure therein and facilitating smoke evacuation, and a second lumen tube extending from the filter cartridge and in communication with the second flow path for delivering insufflation gas to the surgical cavity and detecting intraluminal pressure.

A fitting is operably associated with a distal end of the first lumen tube for connecting with the first mechanically sealed access port, and a fitting is operably associated with a distal end of the second lumen tube for connecting with the second mechanically sealed access port.
There may be at least one filter element disposed in the first flow path of the filter cartridge and/or at least one filter element disposed in the second flow path of the filter cartridge.

These and other features of the gas circulation system and the system of the present invention will become more readily apparent to those skilled in the art to which the present invention relates from the following detailed description of the preferred embodiments taken in conjunction with a brief description of the drawings.

Because those skilled in the art will readily understand, without undue experimentation, how to manufacture and use the gas circulation system and sealed surgical access device of the present invention, preferred embodiments are described in detail below with reference to the drawings.

FIG. 1 is a diagram of a gas delivery system of the present invention during an endoscopic surgical procedure performed within a patient's abdominal cavity, the system including a gas delivery device, gas delivery and return lines extending between the gas delivery device and a remote gas seal module, a first valve seal access port in communication with a gas seal lumen tube attached to the gas seal module, and insufflation and detection lines extending between the gas delivery device and a second valve seal access port. 2 is a perspective view of the filtered tubing set, remote gas seal module, and valve seal access port of the gas delivery system illustrated in FIG. 1. FIG. 3 is an exploded perspective view of a portion of the gas delivery system of FIG. 1 illustrating connections of gas delivery and return lines, a remote gas seal module, a gas seal lumen tube, and a first valve seal access port. 4 is an exploded perspective view of a gas seal module of the gas delivery system shown in FIG. 1, with parts separated for ease of illustration. 5 and 6 are top and bottom perspective views of a nozzle tube element forming part of the gas seal module shown in FIG. 5 and 6 are top and bottom perspective views of a nozzle tube element forming part of the gas seal module shown in FIG. 7 and 8 are cross-sectional views of the gas seal module taken along lines 7-7 and 8-8 of FIG. 7 and 8 are cross-sectional views of the gas seal module taken along lines 7-7 and 8-8 of FIG. FIG. 9 is a diagram of another embodiment of a filtered tubing set for use with the gas delivery device shown in FIG. 1, including a filter cartridge configured to be received in the gas delivery device, a remote gas seal module having a two-part housing, a valve seal access port in communication with a gas seal lumen tube attached to the gas seal module, and gas delivery and return lines extending between the air supply and detection lumen tubes in communication with another valve seal access port. 10 is an enlarged perspective view of a portion of the gas delivery system of FIG. 9 illustrating the gas seal lumen tubes extending between the gas seal module and the first valve seal access port, and between the air delivery lumen tube and the detection lumen tube and the second valve seal access port. FIG. 11 is an enlarged perspective view of the remote gas seal module shown in FIG. FIG. 12 is an exploded perspective view of the remote gas seal module shown in FIG. 9, with parts separated for ease of illustration, including an annular jet assembly for creating a gas seal within a gas seal lumen tube extending therefrom. 13 is an exploded perspective view of an annular jet assembly housed within the gas seal module of FIG. 12. FIG. FIG. 14 is a diagram of another embodiment of a filtered tubing set for use with the gas delivery device shown in FIG. 1 and includes a filter cartridge configured to be received in the gas delivery device, a remote gas seal module, a valve seal access port in communication with a gas seal lumen tube attached to the gas seal module, and gas delivery and return lines extending between the air inlet and sensing lumen tubes in communication with another valve seal access port. 15 is an enlarged perspective view of a portion of the gas delivery system of FIG. 14 illustrating the gas seal lumen tubes extending between the gas seal module and the first valve seal access port, and between the air delivery lumen tube and the detection lumen tube and the second valve seal access port. FIG. 15a is a topographical view of the connector where the gas delivery and return lines are separated from the fittings on the gas seal module. 16 and 17 are cross-sectional views taken along line 16-16 of FIG. 15 illustrating the interior of the remote gas seal module and the connection points of the gas delivery and return lumen tubes. 16 and 17 are cross-sectional views taken along line 16-16 of FIG. 15 illustrating the interior of the remote gas seal module and the connection points of the gas delivery and return lumen tubes. FIG. 18 is a perspective view of a surgical access assembly constructed in accordance with a preferred embodiment of the present invention including a gas seal sleeve having a proximal end portion in communication with a distal end portion of a gas seal lumen tube, and a valve seal tubular access port configured for coaxial reception within the sleeve. 19 is an exploded perspective view of the surgical access assembly shown in FIG. 18 including the valve seal tubular access port separated from the gas seal sleeve. 20 is a perspective view of the filtered tubing set of FIG. 14 in conjunction with the surgical access assembly of FIG. 18 . FIG. 21 is an exploded perspective view of the filtered tubing set shown in FIG. 20 with parts separated for ease of illustration. FIG. 22 is a cross-sectional view taken along line 22-22 of FIG. 23 is a local plan view of the distal end portion of the surgical access assembly shown in FIG. 18. FIG. FIG. 24 is a diagram of another gas delivery system configured in accordance with a preferred embodiment of the present invention, where the gas delivery device includes an internal gas seal module in communication with a gas seal lumen tube extending from the filter cartridge to a valve seal access port, and also includes an air delivery lumen tube and a sensing lumen tube extending from the filter cartridge to a second valve seal access port. 25 is a perspective view of a filtered tubing set employed in the gas delivery device of FIG. 24 having a valve seal access port associated therewith. 26 is a topographical perspective view of the interior of the gas delivery device shown in FIG. 24. FIG. FIG. 27 is a cross-sectional view taken along line 27-27 of FIG. 28 is an exploded perspective view, with parts separated for ease of illustration, of the internal gas seal module positioned within the gas delivery device shown in FIG. 24. FIG. 29 is a schematic diagram of the gas delivery device of FIG. 24 with associated gas flow paths illustrated. 30-37 illustrate four different embodiments of the internal gas seal module shown in FIG. 28 and one nozzle disk for creating the gas seal. 30-37 illustrate four different embodiments of the internal gas seal module shown in FIG. 28 and one nozzle disk for creating the gas seal. 30-37 illustrate four different embodiments of the internal gas seal module shown in FIG. 28 and one nozzle disk for creating the gas seal. 30-37 illustrate four different embodiments of the internal gas seal module shown in FIG. 28 and one nozzle disk for creating the gas seal. 30-37 illustrate four different embodiments of the internal gas seal module shown in FIG. 28 and one nozzle disk for creating the gas seal. 30-37 illustrate four different embodiments of the internal gas seal module shown in FIG. 28 and one nozzle disk for creating the gas seal. 30-37 illustrate four different embodiments of the internal gas seal module shown in FIG. 28 and one nozzle disk for creating the gas seal. 30-37 illustrate four different embodiments of the internal gas seal module shown in FIG. 28 and one nozzle disk for creating the gas seal.

Referring now to the drawings in which like reference numerals identify similar structural elements and features of the present invention, a gas circulation system for performing endoscopic surgical procedures within a patient's surgical cavity, and more particularly, for performing laparoscopic surgical procedures within a patient's abdominal cavity, is illustrated in Figure 1, constructed in accordance with a preferred embodiment of the present disclosure and generally designated by the reference numeral 10. Those skilled in the art will readily appreciate that the gas circulation system 10 of the present invention may be used to perform thoracoscopic surgical procedures within a patient's thoracic cavity, as well as intraluminal surgical procedures, such as transanal and transesophageal surgical procedures.

1, the gas circulation system 10 of the present invention is specifically designed to cooperate with a programmable multi-mode gas delivery device 12. This type of gas delivery device 12 is described, for example, in commonly assigned U.S. Pat. No. 9,375,539, which is incorporated herein by reference.
The disclosure of which is incorporated herein by reference in its entirety. Gas delivery device 12 includes a graphical user interface 14 for setting operating parameters, and a pump 16 for facilitating circulation/recirculation of pressurized gas to a surgical cavity 18 of a patient 20. Gas delivery device 12 is connected to a portable source 22 of surgical gases for delivering insufflation gas to the surgical cavity 18 of a patient 20 by an internal insufflation apparatus 15. Alternatively, gas may be supplied to gas delivery device 12 from a permanent source.

1 in conjunction with FIG. 2, the system 10 further includes a filtered tubing set 30 operatively associated with the gas delivery device 12. The filtered tubing set 30 includes a disposable filter cartridge 32 of the type described in commonly assigned U.S. Patent No. 9,526,849, the disclosure of which is incorporated herein by reference in its entirety. A gas delivery lumen tube 34 and a gas return lumen tube 36 are disposed in the filter cartridge 32.
2 and a remotely located gas seal module 40, which will be described in more detail below. A first valve seal access port 42 communicates with the gas seal module 40 through a gas seal lumen tube 44, and an air delivery line and a sense line 46 extend between the filter cartridge 32 and a second valve seal access port 48. A connector 43
A connector 47 is associated with the distal end of the gas seal lumen tube 44 for mating with fittings on the first access port 42, and a connector 47 is associated with the distal ends of the air supply and detection lines 46 for mating with fittings on the second access port 48.

3, a remote gas seal module 40 (i.e., located away from the access port 42, and gas delivery device 12) is shown along with gas delivery and return lumen tubing 34 and 36, gas seal lumen tubing 44 and first valve seal access port 42. Generally, the remote gas seal module 40 is adapted and configured to generate a gas seal extending through the gas seal lumen tubing 44 to the first valve seal access port 42 to maintain a stable pressure and facilitate smoke evacuation within the surgical cavity 18 of the patient 20 during an endoscopic surgical procedure.

4, the remote gas seal module 40 includes a generally cylindrical proximal housing portion 50 and an elongated tubular stem portion 52 extending axially from the proximal housing portion 50. The proximal housing portion 50 is associated with an end cap 55 having an axially offset inlet port 54 for communication with the gas delivery lumen tube 34, and an adjacent axially offset outlet port 56 for communication with the gas return lumen tube 36.

4 in conjunction with FIGs. 5 and 6, the gas seal module 40 further includes a nozzle body 60 sandwiched between the proximal housing portion 50 and the end cap 55 and defines a crescent shaped inlet plenum 62a for receiving pressurized gas from the pump 16 of the gas delivery device 12 through the gas delivery lumen tube 34 and the inlet 54 of the end cap 55 to create a gas seal within the gas seal module 40, and a crescent shaped outlet plenum 62b for receiving spent gas used to create a gas seal within the gas seal module 40 through the outlet 56 for return to the pump 16 via the gas return lumen tube 36. The crescent shaped plenums 62a and 62b have respective crescent shaped gas conduit channels 63a and 63b.

The nozzle body 60 of the gas seal module 40 further includes a central gas transport plenum 64, which is open to the atmosphere at both ends and is disposed between the inlet plenums 62a and 62b. The nozzle body 60 also includes a distally extending nozzle tube 65 in communication with the gas transport plenum 64. The nozzle tube 65 has a central bore 70 in communication with the gas transport plenum 64.
3 and 4, defining a bidirectional vent path to facilitate gas exchange into and out of the gas seal lumen tube 44, including, but not limited to, the entrainment of air from the atmosphere into the surgical cavity 18, and the venting of gas from the surgical cavity 18 to the atmosphere to relieve overpressure. The outer periphery of the nozzle tube 65 includes a plurality of circumferentially spaced land areas 66 which define a set of circumferentially spaced embedded gas jets 68 for accelerating pressurized gas delivered from the gas delivery lumen tube 34 to the gas seal module 40 to form a gas seal within the gas seal lumen tube 44.

With continued reference to FIG. 4 in conjunction with FIGS. 7 and 8, the proximal housing portion 50 of the gas seal module 40 includes a gas inlet channel 63 of the inlet plenum 62a of the nozzle body 60.
a, and a surrounding annular plenum region 74 in communication with gas return channel 63b of gas return plenum 62b. Annular plenum region 74 includes a plurality of circumferentially spaced gas return ports 75.

A nozzle bore 76 is formed in the central plenum region 72 and, as best seen in Figures 7 and 8, the nozzle tube 65 of the nozzle body 60 is sized and configured to engage within the nozzle bore 76 to form a radially outer boundary of the circumferentially spaced jets 68 embedded in the outer circumferential surface of the nozzle tube 65, as described above.

4 in conjunction with FIGS. 7 and 8, the elongated tubular stem portion 52 extending axially from the proximal housing portion 50 of the gas seal module 40 includes a proximal flange portion 80 housing a plurality of circumferentially spaced fins 82 configured to direct spent gas used to create the gas seal to the annular plenum region 74 via a gas return port 75. The tubular stem portion 52 further includes a plurality of circumferentially spaced jets 62 configured to direct spent gas used to create the gas seal to the annular plenum region 74 via a gas return port 75.
8, which defines an interior region 85 of the gas seal module 40. The stem portion 52 also includes a distal tube fitting 86 that is sized and configured to connect with the gas seal lumen tube 44, as best seen in FIG.

9-12, there is illustrated another filtered tubing set constructed in accordance with a preferred embodiment of the present invention, designated generally by reference numeral 130, which includes a remote gas seal module 140 which differs from the remote seal module 40 described above in that the gas seal delivery and return lumen tubes are offset from and parallel to the gas seal lumen tubes.

More specifically, tubing set 130 includes filter cartridge 132, gas delivery lumen tubing 134, and gas return lumen tubing 136 extending between filter cartridge 132 and gas seal module 140, gas seal lumen tubing 144 extending from gas seal module 140 to a first valve seal access port 142, and air delivery and detection lumen tubing 146 extending from filter cartridge 132 to a second valve seal access port 148. In this embodiment of the invention, gas seal module 140 includes gas delivery lumen tubing 134.
and the gas return lumen tube 136 is configured to be disposed parallel to and offset from the connection of the gas seal lumen tube 144 .

11 and 12, remote gas seal module 140 includes a two-part mechanically interconnected housing assembly 145 comprised of a first component 152 and a subassembly 157. First component 152 is connected to and in communication with gas delivery lumen tubing 134 and gas return lumen tubing 136. Subassembly 157 comprises:
It is connected to and in communication with gas seal lumen tube 144 .

More specifically, dual-part housing 145 component 152 has an inlet port 154 for direct communication with gas delivery lumen tube 134 and an adjacent outlet port 156 for direct communication with gas return lumen tube 136. Dual-part housing 145 subassembly 157 includes a body portion 155 defining an internal plenum chamber 159 and a distally extending tube fitting 186 sized and configured to connect with gas seal lumen tube 144.

The internal plenum chamber 159 of the body portion 155 is sized and configured to receive a two-piece ring jet assembly 190 of the type illustrated in Figure 13 and described in more detail in commonly assigned U.S. Patent No. 9,907,569, the disclosure of which is incorporated herein by reference in its entirety. Generally, as shown in Figure 13, the two-piece ring jet assembly 190 consists of an upper member 192 having an O-ring seal 193, and a lower ring member 194 having an O-ring seal 195.

Jet assembly 190 serves to receive pressurized gas from gas delivery lumen tube 134 through inlet port 163 and accelerate the gas to create a gas seal within distal throat region 184 of body portion 155 (see FIG. 10 ). The gas seal created in throat region 184 maintains a steady pressure and provides a constant pressure distribution throughout surgical cavity 1 of patient 20 during an endoscopic surgical procedure.
8 creates a stable pressure barrier that maintains a stable pressure throughout the length from the gas seal lumen tube 144 to the access port 142 to facilitate smoke evacuation within the gas seal lumen tube 144 .

As best seen in FIG. 12, circumferentially spaced guide fins 182 guide the gas used to create a gas seal in throat region 184 toward the outlet fitting 17.
1 and 2. Component 152 includes a plenum chamber 159 in body portion 155 for directing gases through gas seal lumen tube 144 back to gas return lumen tube 136 via gas seal lumen tube 144. Component 152 also includes a vent path 188 for facilitating gas exchange in and out of gas seal lumen tube 144, including, but not limited to,
This includes the incorporation of air from the atmosphere into the surgical cavity 18 and the venting of gas from the surgical cavity 18 to the atmosphere to relieve overpressure.

14-17, there is illustrated yet another filtered tubeset constructed in accordance with a preferred embodiment of the present invention, generally designated by the reference numeral 230, which includes a remote gas seal module 240 that is distinct from each of the remote seal modules described above. More specifically, tubeset 230 includes a filter cartridge 240.
32, gas delivery lumen tube 234, and gas return lumen tube 236 extending between filter cartridge 232 and gas seal module 240, gas seal lumen tube 244 extending from gas seal module 240 to a first valve seal access port 242, and air delivery and detection lumen tubes 246 extending from filter cartridge 232 to a second valve seal access port 248.

In this embodiment of the invention, gas seal module 240 is configured such that gas delivery lumen tube 234 and gas return lumen tube 236 are positioned perpendicular to the outlet of gas seal lumen tube 244 and such that gas delivery lumen tube 234 and gas return lumen tube 236 are positioned to connect with housing 250 of gas seal module 240 in a concentric configuration.

More specifically, gas delivery lumen tube 234 and gas return lumen tube 236 are operatively associated with a rotatable dual lumen concentric connector 235 that mates with a correspondingly configured fitting 245 extending from a housing 250 of gas seal module 240 perpendicular to the connection of gas seal lumen tube 244, as best seen in FIG. 15a. Connectors of this type are disclosed in commonly assigned U.S. Patent Application Publication No. 2017/003331, filed on Oct. 13, 2017.
No. 3,361,084, the disclosure of which is incorporated herein by reference in its entirety. Housing 250 of gas seal module 240 further includes louvered vents 280 that facilitate two-way gas exchange with atmosphere (i.e., for aeration and overpressure relief through lumen tube 244) and are disposed in-line with gas seal lumen tube 244, as best seen in FIGS.

In this embodiment of the invention, the gas seal module 240 includes a two-piece ring jet assembly 290 of the type shown in FIG. 13 and described in commonly assigned U.S. Pat. No. 9,907,569 for creating a gas seal with the interior region 285 of the throat portion 284 of the housing 250, which maintains a stable pressure and provides a gas seal to the patient 20 during the endoscopic surgical procedure.
The gas seal creates a stable pressure barrier that maintains a stable pressure through the length of the gas seal lumen tube 244 up to the access port 242 to facilitate evacuation of smoke within the surgical cavity 18 .

18-23, there is illustrated a surgical access assembly 300 adapted and configured for use in conjunction with any one of the filtered tubing sets previously described, such as, for example, the filtered tubing set 230 shown in FIG. 14. The surgical access assembly 300 primarily includes a tubular gas seal sleeve 342 and a valve seal access port 348. The tubular gas seal sleeve 342 is fitted with a fitting 344 for communicating with a connector 247 on a distal end portion of the gas seal lumen tube 244 of the tubing set 230.
7. Valve seal access port 348 is configured for coaxial mounting within tubular sleeve 342, provides mechanically sealed instrument access to surgical cavity 18, and has fittings 349 for communicating with connectors 249 on the distal ends of air delivery and detection lumen tubes 246 of tubing set 230.

22 and 23, the access port 348 has a proximal housing 365 that houses a duckbill seal 367 for providing gas-tight access to the surgical cavity 18 through a central lumen tube 369 of the access port 348. With particular reference to FIG. 22, the central lumen tube 369 provides the air insufflation and detection lumen tubes for the system 300, and an elongated annular channel 353 is formed between the inner periphery of the gas seal sleeve 342 and the outer periphery of the access port 348 such that the gas seal lumen tube 244 communicates with the surgical cavity 18 to maintain a stable pressure and facilitate evacuation of smoke within the surgical cavity 18.

A seal ring 355 is attached to sleeve 34 to seal the proximal end of annular channel 353.
2, as best seen in FIG. 23, is associated with the proximal end portion 343 of annular channel 3
53 and a plurality of circumferentially spaced channels 3 for facilitating communication between the surgical cavity of the patient.
57 is formed at a distal end portion 359 of the gas seal sleeve 342 to maintain a stable pressure within the surgical cavity and to facilitate smoke evacuation during an endoscopic surgical procedure.

In use, the access assembly 300 is used to access the surgical cavity 18 during an endoscopic surgical procedure.
To access the gas supply to the patient, the valve seal port 348 is first attached to the gas seal sleeve 342, and then the gas seal sleeve 342 together with the valve seal port 348 is attached to the patient 2.
0 into the surgical cavity 18. The angled distal edge 363 of the valve sealing port 348 aids in the percutaneous introduction of the assembly 300, which is accomplished using a typical obturator or introducer disposed therein, as is well known in the art.

The method further includes connecting a fitting 247 on the end of the gas seal lumen tube 244 to a fitting 347 on the sleeve 342 adapted for bidirectional gas flow into and out of the gas seal sleeve 342, and connecting fittings 249 on the ends of the air delivery and detection lumen tubes 246 to fittings 349 on the valve seal port 348. If a metallic access device is used with the system, the sleeve 342 may be
It is assumed that it will need to be earthed to prevent electric shock resulting from capacitive coupling.

24, there is illustrated a unique gas delivery system 400 constructed in accordance with a preferred embodiment of the present invention. The gas delivery system 400 includes a gas delivery device 412 having an internal gas seal module 440, as opposed to the external, remotely located gas seal module described above. The gas delivery device 412 also includes a graphical user interface 414 for setting operational parameters, receiving insufflation gas from a gas source,
An internal insufflation system 415 for delivering that gas to the patient's surgical cavity, and a pump 416 for facilitating circulation/recirculation of pressurized gas to an internal gas seal module 440. The insufflation system 415 and gas seal module 440 communicate with a unique filtered tubing set 430, as best seen in FIG.

25, the filtered tubing set 430 includes a filter cartridge 432 having a gas seal lumen tube 444 and an air delivery and detection lumen tube 446 extending therefrom. The gas seal lumen tube 444 extends from the filter cartridge 432 to a first valve seal access port 442, and the air delivery and detection lumen tube 446 extends to a second valve seal access port 448. The internal gas seal module 440 maintains a stable pressure through the gas seal lumen tube 444 to the first access port 442 to create a gas seal that creates a stable pressure barrier that facilitates smoke evacuation within a patient's surgical cavity during an endoscopic surgical procedure.

26-27 in conjunction with the schematic diagram of FIG. 29, the interior of the housing 413 of the gas delivery device 412 is illustrated, which includes a receiving cavity 417 for removably receiving a cartridge 432 of a filtered tubing set 430, which communicates with an internal gas seal module 440 by an internal gas seal tube 425. The filter cartridge 432 includes a first filter element 43 for filtering the insufflation gas flow to an air delivery conduit 446.
29, the filter cartridge 432 includes a second filter element 433 for filtering gas entering and exiting the gas seal lumen tube 444. Although the filter cartridge 432 has been described as being part of a replaceable and disposable tubing set 430, the filter element 433 may be a removable, removable, removable replacement part.
One or both of the gas delivery devices 412 and 433 may be connected to the housing 41
3 may be in the form of a removable filter element attached to the internal compartment within
This is fully contemplated and within the scope of the present disclosure (see, for example, internal filter 457).

An internal air insufflation tube 419 extends between the air insufflation device 415 and the receiving cavity 417. Additionally, an internal gas delivery conduit 421 extends from the high pressure outlet side of the pump 416 to the gas seal module 417.
40 and an internal gas return conduit 423 extends between the outlet side of gas seal module 440 and the inlet or suction side of pump 416 .

26 in conjunction with FIG. 28, the gas seal module 440 is supported on the housing 413 of the gas delivery device 412 on an upright bracket 427 that includes a louvered vent plate 429 to accommodate gas exchange, including but not limited to air entrainment from the atmosphere into the gas seal module 440 and air flow through the gas seal module 440.
29, an embodiment of the gas delivery device 412 includes an internal vent tube 455 that extends from the housing 450 of the gas seal module 440 to an internal filter element 457. The internal filter 457 communicates with an outlet tube 459 that extends from the housing 413 to the atmosphere to facilitate gas exchange.

The housing 450 of the gas seal module 440 is sized and configured to support a pressurized nozzle assembly 490, which is adapted and configured to accelerate pressurized gas to create a gas seal in a throat section 484 that extends from the housing 450 to the gas seal tube 425. The nozzle assembly 490 includes an upper ring component 492 having an associated O-ring seal 493, and an upper ring component 494 having an associated O-ring seal 494.
95. As described in more detail below, the nozzle disc 494 includes one or more gas acceleration nozzles.

As best seen in FIG. 27, gas inlet plenum 497 includes internal gas delivery conduit 421.
The lower surface of the upper ring component 492 and the lower nozzle disc 4
94. More specifically, the housing 450 is formed between the upper surface of the gas delivery conduit 4
21, and an outlet port 453 for communication with a gas return conduit 423. The nozzle assembly 490 defines a vent path 499 to facilitate two-way gas exchange with the atmosphere by emission through a louvered vent plate 429.

30-37, there are illustrated four different embodiments of a metal nozzle disk, each of which, as described above, includes the internal gas seal module 4 shown in FIG.
40. In these embodiments, each metal disk 594 has at least one radially inwardly angled nozzle 596, gas seal lumen tube 440, and nozzle 442 therein for accelerating pressurized gas received from pump 416 to create a gas seal within internal gas seal module 444 of gas delivery device 412.
44 and an O-ring seal 595 to separate and seal the high and low pressure sides of the disk 594 within the housing 450 of the module 440.

30 and 31, an embodiment of the disk 594 has a cylindrical bore 59
32 and 33, includes one radially inwardly angled nozzle 596 radially spaced from a cylindrical bore 598, both of which are offset from a central axis of the disk 594. An alternative embodiment of the disk 594 includes one radially inwardly angled nozzle 596 radially spaced from a cylindrical bore 598, both of which are offset from a central axis of the disk 594, as shown in FIG.
It has a number of radially inwardly angled nozzles 596 therein, all offset from the central axis of the disk.

In another embodiment, the disk 594 has a plurality of radially inward angled jet nozzles 596 formed within and surrounding a cylindrical bore 598 that is axially aligned with the central axis of the disk 594, as shown in Figures 34 and 35. In yet another embodiment of the disk 594, as shown in Figures 36 and 37, there is one radially inward angled nozzle 596 that receives pressurized gas through a radial inlet passage 597 extending from the outer periphery of the disk 594, and the cylindrical bore 598 is axially aligned with the central axis of the disk 594.

In essence, the cylindrical bore 598 in each of these metal disks 594 serves the same function as the central bore of a ring jet assembly for a gas seal access port (see U.S. Pat. No. 8,795,223), which is centrally located and allows for the passage of instruments. However, because the jet disks 594 are internal to the gas delivery device 412 and do not need to accommodate an instrument passage, the cylindrical bore 598 in each disk 594 can be less large and off-center located, since it does not need to form an airtight seal around a cylindrical instrument passing through the access port. This bore is
It is cylindrical for ease of manufacture, but this need not be the case.

While the subject disclosure has been shown and described with reference to preferred embodiments, it will be apparent to those skilled in the art that
It will be readily apparent that changes or modifications can be made without departing from the scope of the subject disclosure.

Claims (5)

1. A filtered tubing set for use with a gas delivery device for performing an endoscopic surgical procedure within a surgical cavity, comprising:
a) a filter cartridge having first and second flow passages formed therein;
b) a first lumen tube extending from said filter cartridge and in communication with said first flow path and in communication with said surgical cavity for maintaining a stable pressure within said surgical cavity and facilitating evacuation of smoke from said surgical cavity ;
the stable pressure is maintained by a gas seal module including a nozzle assembly for accelerating pressurized gas;
the gas seal module is supported within the gas delivery device on a housing of the gas delivery device;
the housing of the gas delivery device includes a receiving cavity that removably receives the filter cartridge;
the gas seal module communicates with the receiving cavity of the gas delivery device through an internal gas seal tube;
the first lumen tube, the filter cartridge configured to communicate with the gas seal module and the first flow path through the internal gas seal tube when received in the receiving cavity;
c) a filtered tubing set including a second lumen tube extending from said filter cartridge and in communication with said second flow path for delivering insufflation gas to said surgical cavity and for sensing pressure within said surgical cavity. The filtered tubing set of claim 1 , wherein a fitting for connecting a first valve seal access port and the first lumen tube is operatively associated with a distal end of the first lumen tube. The filtered tubing set of claim 1 , wherein a fitting for connecting a second valve seal access port and the second lumen tube is operatively associated with a distal end of the second lumen tube. The filtered tube set of claim 1 , wherein at least one filter element is disposed within the first flow passage of the filter cartridge. The filtered tube set of claim 1 , wherein at least one filter element is disposed within the second flow path of the filter cartridge.

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